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BPS Pharmacotherapy (Part1 and Part2) Sample Questions:

1. A drug use evaluation (DUE) of an institution's ACLS medication administration records yields the following data:
* Rate of amiodarone use in patients with asystole = 30%
* Rate of amiodarone use in patients with ventricular fibrillation = 90%
* Rate of epinephrine use in patients with pulseless electrical activity (PEA) = 98%
* Rate of vasopressin use in patients with pulseless ventricular tachycardia = 50% Which of the following treatments should be targeted for intervention?

A) Pulseless ventricular tachycardia
B) Asystole
C) Ventricular fibrillation
D) Pulseless electrical activity

2. A 24-year-old woman with bipolar disorder is admitted for arthroscopic surgery. Baseline laboratory studies reveal leukocytosis. Which drug is most likely to elevate WBCs and lead to an erroneous interpretation?

A) Olanzapine
B) Valproic acid
C) Lithium
D) Carbamazepine

3. A 49-year-old man presents to his physician with a 3-day acute attack of gout in four joints of the right foot. The patient has a history of at least three previous gout attacks; in one, a joint aspirate was positive for urate crystals. His history also includes type 2 diabetes mellitus and two calcium oxalate kidney stones.
Laboratory values include creatinine 3.1 mg/dL, uric acid 11.7 mg/dL, and A1C 6.8%. The patient is allergic to aspirin. Vital signs are BP135/82mm Hg and HR 90 bpm and regular.
Current medications are glipizide 10 mg daily and enalapril 20 mg daily.
Which short-term regimen is most appropriate for treating this patient's gout?

A) Colchicine 0.6 mg hourly
B) Prednisone 40 mg daily
C) Indomethacin 50 mg three times daily
D) Celecoxib 200 mg daily

4. A patient with diabetic ketoacidosis is receiving 0.9% NaCl, with potassium chloride 20 mEq/L, at 200 mL/h, and regular insulin 8 units/h, intravenously. After 8 hours, the blood glucose is
250 mg/dL and the anion gap is elevated. At this point, which of the following is the most appropriate therapy?

A) Convert to subcutaneous regular insulin and reduce fluids to a keep-vein-open rate.
B) Continue the insulin infusion rate and change to dextrose-containing fluids.
C) Discontinue the insulin and maintain current fluids.
D) Continue the current insulin and fluid therapy.

5. A 58-year-old man presents complaining of unsteady gait. Past medical history is significant for diabetes mellitus, gastroparesis, and depression. The patient exhibits a slight shuffling gait, mild limb rigidity, and decreased speed in performing rapid alternating movement. Current daily medications are bupropion, glyburide, metoclopramide, and omeprazole. Which of the following would be the most appropriate initial management for the presenting complaint?

A) Begin ropinirole.
B) Discontinue metoclopramide.
C) Discontinue bupropion.
D) Begin carbidopa/levodopa.

Solutions: